Perhitungan Dosis Untuk Anak (contoh 2)Contoh soal sediaan Serbuk :R/ Atropin sulfat 0,5 mg (DM sekali: 1 mg, DM sehari 3 mg)      Sacchar.lact.    qs     m.f.pulv. d.t.d. no.X.     S. t.d.d. Pulv. IPro: Rifki (12th)

Analisa resep : dari resep diketahui untuk membuat 10 bungkus serbuk sediaan, mengandung 0,5 mg atropin sulfat setiap bungkus, aturan pakai 3 kali sehari satu bungkus.

Jawab  :

a. DM sekali pakai untuk anak 12 tahun

DM sekali pakai = (12/20) x 1 mg = 0,6 mg DM atropin sulfat sekali pakai

sedangkan untuk Persentase DM sekali :

= (0,5/0,6 mg) x 100% = 83,3% (boleh diracik dan diserahkan karna tidak lebih dari 100%)

b. DM untuk sehari  untuk anak 12 tahunDM sehari = (12/20) x 3 mg = 1,8 mg DM dosis atropin untuk sehari .

Sedangkan untuk Persentase DM searah sehari :

= (3x0,5)/1,8 x 100% = 83,3 % (boleh diracik dan diserahkan karna tidak lebih dari 100%)

Untuk Lebih lengkap maka saya tambahkan rumus dibawah ini :Rumus menghitung dosis untuk anak-anak :1. Berdasarkan umur

a. Rumus young (untuk anak <8 tahun)

      n : umur dalam tahun

b. Rumus dilling (untuk anak lebih Besar atau sama dengan 8 tahun)

 

n : umur dalam tahun

c. Rumus Fried  (untuk bayi)

  n : umur dalam bulan

Disadur dari : farmasi UNISB

Dosis adalah takaran obat yang diberikan kepada pasien yang dapat memberikan efek farmakologis (khasiat) yang diinginkan. dosis dibagi menjadi 2: dosis lazim dan dosis maksimum/maksimal. Dosis lazim adalah dosis yang digunakan sebagai pedoman umum pengobatan, sifatnya tidak mengikat (biasanya diantara dosis mimimum efek dan dosis maksimum), sedangkan dosis maksimum adalah dosis yang terbesar yang masih boleh diberikan kepada pasienbaik untuk pemakaian sekali maupun sehari tanpa membahayakan.Takaran dosis yang ada dalam farmakope umumnya untuk dosis orang dewasa, sedangkan untuk anak-anak memerlukan rumus perhitungan tertentu.

Cara menghitung dosis untuk anak-anak :1. Berdasarkan umura. Rumus young (untuk anak <8 tahun)

     n : umur dalam tahun

b. Rumus dilling (untuk anak Besar-sama dengan 8 tahun)

  n : umur dalam tahun

c. Rumus Fried  (untuk bayi)

  n : umur dalam bulan    2. Berdasarkan berat badanPerhitungan dosis berdasarkan berat badan sebenarnya lebih tepat karna sesuai dengan kondisi pasien ketimbang umur yang terkadang tidak sesuai dengan berat badan, bila memungkinkan hitung dosis melalui berat badand. Rumus Thermich

             n : berat badan dalam kilogram

3. Rumus untuk menentukan persentase DM obat

Persentase DM sekali :

Persentase DM sehari :

Category Archives: Obat yang aman untuk ibu Hamil & MenyusuiDrugsafety – Antikonvulsan, Obat Tidur, Sedatif, dan   Migren DEC 30

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Antikonvulsan, Obat Tidur, Sedatif, dan Migren

Nama Obat R.Hamil R.Menyusui

SumatriptanC L3

Chloral hydrate C L3

Methyprylon - NR

Bromide D L5

Secobarbital D L3

Zolpidem B L3

Bishydroxycoumarin - NR

Warfarin D L2

Carbamazepine C L2

Ethosuximide C L4

Magnesium sulfate B L1

Phenytoin DL2

Valproic acidD

L2

Lactation Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

Pregnancy Risk Categories

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy) NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – Obat TBC dan   Malaria DEC 30

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Obat TBC dan Malaria

Nama Obat Risiko Kehamilan Risiko Menyusui

Obat TB

Cycloserine C L3

Ethambutol B L2

Isoniazid C L3

Rifampin C L2

Obat malaria

Chloroquine C L3

Hydroxychloroquine C L2

Pyrimethamine C L4

Quinine D L2

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – Anti Hipertensi, Anti Aritmia, dan   Diuretik DEC 30

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Anti Hipertensi, Anti Aritmia, dan Diuretik

Nama Generik

Kategori Risiko

Kehamilan** RisikoMenyusui**

Acetazolamide C L2

Bendroflumethiazide D L4 (may inhibit lactation)

Chlorothiazide D L3

Chlorthalidone D L3

Hydrochlorothiazide (HCT) D L2

Spironolactone D L2

Disopyramide C L2

Flecainide C L3

Mexiletine B L2

Procainamide C L3

Quinidine C L2

Captopril D L3 (if used after 30 days)

Diltiazem/Diltiazem HCL C L3

Enalapril/Enalapril MaleateC (1st trim.)

D (2nd, 3rd trim.) L2

Hydralazine C L2

Labetalol C L2

Methyldopa C L2

Metoprolol B L3

Minoxidil C

L2(topically)

L3 (orally)

Nadolol C L4

Nifedipine C L2

Oxprenolol- NR

Propranolol C L2

Sotalol B L3

Timolol C L2

Verapamil C L2

Digoxin C L2

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding*  Per

the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk,

revised September 2001. Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May

Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some

Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – Anti Jamur dan Anti   Virus DEC 30

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Anti Jamur dan Anti Virus

Nama Generik Risiko Kehamilan RisikoMenyusui

Antijamur

Fluconazole C L2

Ketoconazole C L2

Antivirus

Acyclovir C L2

Interferon-alpha C L2

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human

Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May

Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some

Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety –   Antibiotik DEC 27

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Antibiotik

Nama Generik

Kategori Risiko

Kehamilan Risiko Menyusui

Amoxicillin B L1

Aztreonam B L2

Cefadroxil B L1

Cefazolin B L1

Cefotaxime B L2

Cefoxitin B L1

Cefprozil C L1

Ceftazidime B L1

Ceftriaxone B L2

Ciprofloxacin C L3

Clindamycin B L3

Erythromycin B

L1

L3 early postnatal

Fleroxacin- NR

Gentamicin C L2

Kanamycin D L2

Moxalactam- NR

Nitrofurantoin B L2

Ofloxacin C L2

Penicillin B L1

Streptomycin D L3

Sulbactam- NR

Sulfisoxazole C L2

Tetracycline D L2

Ticarcillin B L1

Trimethoprim/sulfamethoxazole C L3

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human

Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May

Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some

Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – Antasida, Laksan (Pelancar BAB) dan Obat   Diare DEC 27

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Antasida, Laksan (Pelancar BAB) dan Obat Diare

Nama Generik Risiko Kehamilan Risiko Menyusui

Cimetidine (Antacid) B L2

Cisapride (GI tract stimulant) C L2

Domperidone (used for nausea & vomiting, stimulates lactation) - L1

Cascara/Cascara Sagrada C L3

Danthron - NR

Magnesium sulfate B L1

Senna - L3

Loperamide B L2

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human

Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May

Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some

Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety –   Antihistamin DEC 27

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Antihistamin

Nama Obat

AAP

approved?

* Risiko Menyusui**

Brompheniramine

not

reviewed L3 (moderately safe)

Chlorpheniramine (Chlor-Trimeton) CTM

not

reviewed L3 (moderately safe)

Cetirizine (Zyrtec)

not

reviewed L2 (safer)

Dexbrompheniramine maleatewith d-isoephedrine

yes not reviewed

Diphenhydramine (Benadryl)

not

reviewed L2 (safer)

Doxylamine

not

reviewed L4 (possibly hazardous)

Fexofenadine (Allegra)

yes L3 (moderately safe)

Loratadine (Claritin)yes L2 (safer)

Terfenadine (Seldane)

yes not reviewed

Triprolidine (Actidil, Actifed)

yes L1 (safest)

*  Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human

Milk, revised September 2001.

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May

Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some

Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – Obat Asma, Obat Batuk, dan Spray   Hidung DEC 27

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

Obat Asma, Obat Batuk, dan Spray Hidung

Nama GenerikKategori Risiko Kehamilan** RisikoMenyusui**  

Dyphylline C L3  

Terbutaline B L2  

Theophylline C L3  

Nama Obat Risiko Menyusui**  

Codeine L3 (moderately safe)  

Dextromethorphan L1 (safest)  

Guaifenesin L2 (safer)  

Phenylephrine L3 (moderately safe)  

Pseudoephedrine (Sudafed, Actifed)

L3 (moderately safe) for acute useL4 (possibly hazardous) for chronic use due to potential for decreasing milk supply  

Beclomethasone (Vanceril, Beclovent, Beconase, Vancenase) L2 (safer)  

Cromlyn sodium (Nasalcrom) L1 (safest)  

Fluticasone (Flonase) L3 (moderately safe)  

Mometasone (Nasonex) L3 (moderately safe)  

Phenylephrine (in some forms of Sinex and Neo-Synephrine) L3 (moderately safe)  

Triamcinolone Acetonide (Nasacort) L3 (moderately safe)

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety – NSAIDs dan   Steroid DEC 27

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

NSAIDs dan Steroid

Nama GenerikKategori Risiko Kehamilan** RisikoMenyusui**

Azapropazone (apazone) - L2

Dipyrone - NR

Flufenamic acid - NR

IbuprofenB (1st, 2nd trim.)D (3rd trim.) L1

IndomethacinB (1st, 2nd trim.)D (3rd trim.) L3

KetorolacB (1st, 2nd trim.)D (3rd trim.) L2

Mefenamic acid - NR

Naproxen BL3L4

Phenylbutazone - NR

Piroxicam B L2

Suprofen - NR

Tolmetin C L3

Methylprednisolone C L2

Prednisolone C L2

Prednisone C L2

 Lactation Risk Categories L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

Pregnancy Risk Categories A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk)

X (contraindicated in pregnancy) NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety –   ANALGETIK DEC 26

Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI

ANALGETIK

Nama Obat Risiko Kehamilan Risiko Menyusui

Acetaminophen (Tylenol) B L1

AspirinC (1st, 2nd trim.)

D (3rd trim.) L3

Azapropazone (Rheumox)-

L2

Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne) D L3

Butorphanol  (Stadol)B (1st, 2nd trim.)

D (3rd trim.) L3

Celecoxib (Celebrex)) C L2

Codeine (in Tylenol #3, #4) C L3

Colchicine D L4

Diclofenac (Cataflam, Voltaren) B L2

Fentanyl  (Sublimaze) B L2

Flurbiprofen (Ansaid, Froben, Ocufen)

B (1st, 2nd trim.)

C (3rd trim.) L2

Hydrocodone (Lortab, Vicodin) B L3

Hydromorphone(Dilaudid) C L3

Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)

B (1st, 2nd trim.)

D (3rd trim.) L1

Indomethacin (Indocin)B (1st, 2nd trim.)

D (3rd trim.) L3

Ketorolac (Toradol, Acular)B (1st, 2nd trim.)

D (3rd trim.) L2

Meperidine (Demerol) B

L2;

L3 early postpartum

Methadone (Dolophine) B L3

Morphine (Duramorph, Infumorph, Epimorph, MS Contin) B L3

Nalbuphine (Nubain) B L2

Naproxen (Anaprox, Naprosyn, Naproxen, Aleve) B

L3;

L4 for chronic use

Nefopam (Acupan)- NR

Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet) B L3

Pentosan polysulfate(Elmiron) B L2

Piroxicam (Feldene) B L2

Propoxyphene(Darvocet N, Propacet, Darvon) C L2

Secobarbital (Seconal) D L3

Tolmetin (Tolectin) C L3

Tramadol HCL(Ultram, Ultracet) C L3

ButorphanolB (1st, 2nd trim.)

D (3rd trim.) L3

Codeine C L3

Fentanyl B L2

Meperidine B

L2

L3 (if used early postpartum)

Methadone B L3

Morphine B L3

Propoxyphene C L2

** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

 Lactation Risk Categories  Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated) A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.

1. Aspirin use is discouraged in children and nursing mothers due to the risk o2. f Reye’s syndrome and internal bleeding.3. Fioricet (Fiorinal, Bancap, Two-dyne) contains acetaminaphen or asprin, caffeine, and

butalbital. Per Hale, baby should be observed for sedation.4. Hale suggests weakened or premature infants be observed for sedation and apnea.5. Hale suggests newborns be observed for sedation, apnea, constipation.6. Per Hale, use of frequent, higher dose may result in infant sedation.7. Per Hale, Meperidine use during labor or early postpartum has been associated with

sedation, poor sucking reflex, and neurobehavioral delay in infants.8. Per Hale, observe infant for sedation, respiratory depression, addiction, withdrawal

syndrome.9. Per Hale, higher doses may result in infant sedation.

10. Per Hale, should be used with caution due to its long half-life and its effect on baby’s cardiovascular system, kidneys and GI tract; short-term, infrequent or occasional use is not necessarily incompatible with breastfeeding.

11. Roxicet, Endocet, Roxiprin, Percocet also contain acetaminophen. Per Hale, observe infant for sedation.

12. Per Hale, observe infant for sedation.13. Per Hale, observe infant for GI cramping, distress, diarrhea.14. Per Hale, observe infant for sedation.15. Per Hale, observe infant for sedation.

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